Etiology

Primary Renal Disease

• Acute Kidney Injury (AKI) (see Acute Kidney Injury)
  • Physiology
    • XXX
• Chronic Kidney Disease (CKD) (see Chronic Kidney Disease)
  • Physiology
    • XXX

Drug

• Cimetidine (Tagamet) (see Cimetidine)
  • Physiology
    • Due to Decreased Tubular Secretion of Creatinine
• Dronedarone (Multaq) (see Dronedarone)
  • Physiology
    • Due to Impairment of renal tubular creatinine secretion
• Sulfamethoxazole-Trimethoprim (Bactrim, Septra) (see Sulfamethoxazole-Trimethoprim)
  • Physiology
  • Due to Trimethoprim-Associated Decreased Tubular Secretion of Creatinine Transporters

Toxin

• Isopropanol Intoxication (see Isopropanol)
  • Epidemiology
    • May Occur with Acetone Concentration >100 mg/dL

Other

• Intense Exercise
  • Physiology
    • Increased Muscle Breakdown

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Physiology of Creatinine

Determinants of Serum Creatinine

• Rate of Creatinine Production
• Apparent Volume of Distribution for Creatinine
• Rate of Creatinine Elimination

Serum Creatinine Levels in Critically Ill Patients

• Use of Creatinine to Determine an Estimate of the Glomerular Filtration Rate in Critically Ill Patients is Limited, Since Creatinine is Not in a Steady-State
• Use of Creatinine Lacks Sensitivity and Underestimates the Degree of Renal Dysfunction in Critically Ill Patients
  • Increase in Serum Creatinine Lag Behind a Reduction in the Glomerular Filtration Rate

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References

• Dronedarone: a new antiarrhythmic agent. Drugs Today 2006;42:75-86
• Effect of dronedarone on cardiovascular events in atrial fibrillation. N Engl J Med 2009;360:668-678